呼吸重症监护室机械通气患者的潮气末与动脉血 PCO2 比值作为预后值

Mohamed Mustafa Mohamed, Gahan Mohamed Elassal, Hossam M. Abdel Hamid
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摘要

死腔是指每个潮气量中不参与气体交换的部分。它是肺功能效率的一个指标。 目的:评估潮气末-动脉PCO2比值和急性生理与慢性健康评估(APACHE IV)评分系统作为呼吸重症监护室(ICU)机械通气患者预后值的作用。 这项前瞻性队列研究的对象是艾因-沙姆斯大学医院呼吸重症监护室收治的 40 名因不同呼吸原因接受机械通气治疗的患者。 研究发现,潮气末 PCO2(PETCO2)/动脉二氧化碳(PaCO2)的降低与呼吸重症监护室机械通气病例的死亡率升高有关。在机械通气 1 小时后和 24 小时后,APACHE IV 评分与潮气末 PCO2 与动脉血 PCO2 的比率呈明显负相关。APACHE IV 评分与死亡率有明显关系,幸存者的死亡率高于非幸存者。 PETCO2/PaCO2 是反映呼吸重症监护病房机械通气患者死腔通气情况的相关预后值。APACHE IV 评分是预测呼吸重症监护病房患者死亡率的良好指标。
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End-tidal-to-arterial PCO2 ratio as a prognostic value in mechanically ventilated patients at respiratory intensive care unit
Dead space refers to the part of each tidal volume that does not contribute to gas exchange. It serves as an indicator of lung function efficiency. To evaluate the end-tidal-to-arterial PCO2 ratio and Acute Physiological and Chronic Health Assessment (APACHE IV) scoring system as prognostic values in mechanically ventilated patients at the respiratory intensive care unit (ICU). This prospective cohort research was done on 40 mechanically ventilated patients due to different respiratory causes who were admitted at the respiratory ICU at Ain Shams University hospitals. This study found that decreasing end tidal PCO2 (PETCO2)/arterial carbon dioxide (PaCO2) is associated with higher mortality amongst mechanically ventilated cases in respiratory ICU. A significant negative association between APACHE IV score and end-tidal to arterial PCO2 ratio following 1 h and after 24 h of mechanical ventilation. APACHE IV score showed a significant relation with mortality, being higher in survivors than nonsurvivors. PETCO2/PaCO2 is a relevant prognostic value that reflects dead space ventilation among mechanically ventilated patients in respiratory ICU. APACHE IV score is a good mortality predictor in respiratory ICU.
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